Characteristics, Comorbidities, and Outcomes in a Multicenter Registry of Patients With Human Immunodeficiency Virus and Coronavirus Disease 2019

Abstract

Background People with HIV (PWH) may have numerous risk factors for acquiring Coronavirus disease-19 (COVID-19) and developing severe outcomes, but current data are conflicting. Methods Healthcare providers enrolled consecutively by non-random sampling PWH with lab-confirmed COVID-19, diagnosed at their facilities between April 1st and July 1st, 2020. De-identified data were entered into an electronic Research Electronic Data Capture (REDCap). The primary endpoint was severe outcome, defined as a composite endpoint of intensive care unit (ICU) admission, mechanical ventilation, or death. The secondary outcome was the need for hospitalization. Results 286 patients were included; the mean age was 51.4 years (SD, 14.4), 25.9% were female, and 75.4% were African-American or Hispanic. Most patients (94.3%) were on antiretroviral therapy (ART), 88.7% had HIV virologic suppression, and 80.8% had comorbidities. Within 30 days of positive SARS-CoV-2 testing, 164 (57.3%) patients were hospitalized, and 47 (16.5%) required ICU admission. Mortality rates were 9.4% (27/286) overall, 16.5% (27/164) among those hospitalized, and 51.5% (24/47) among those admitted to an ICU. The primary composite endpoint occurred in 17.5% (50/286) of all patients and 30.5% (50/164) of hospitalized patients. Older age, chronic lung disease, and hypertension were associated with severe outcomes. A lower CD4 count (<200 cells/mm³) was associated with the primary and secondary endpoints. There was no association between the antiretroviral regimen or lack of viral suppression and predefined outcomes. Conclusion Severe clinical outcomes occurred commonly in PWH and COVID-19. The risk for poor outcomes was higher in those with comorbidities and lower CD4 cell counts, despite HIV viral suppression.

Clinical characteristics and outcomes of people living with HIV hospitalized with COVID-19: a nationwide experience

“…This is similar than another report of hospitalized PLHIV with COVID-19 9,27 but higher than other multi-centre report. 28 Our cohort required ICU admission in 22% of cases, similar to the cohort of Shalev from New York. 29 However, we saw lower rates of need for mechanical ventilation (8.3%) and inhospital mortality (13.9%) than other cohorts of PLHIV.…”

The characteristics of HIV-positive patients with mild/asymptomatic and moderate/severe course of COVID-19 disease—A report from Central and Eastern Europe

“…Each of these is important for investigation of the HIV and SARS-CoV-2 interplay in death causality. The relation between the severity of the COVID-19 disease and HIV specific factors, such as particular cART components, was possible only in few studies ( Dandachi et al, 2020 ). In our study, we analyzed the risk factors for moderate/severe courses of COVID-19 among HIV-positive patients reported by CEE countries.…”

The characteristics of HIV-positive patients with mild/asymptomatic and moderate/severe course of COVID-19 disease – a report from Central and Eastern Europe

“…Each of these is important for investigation of the HIV and SARS-CoV-2 interplay in death causality. The relation between the severity of the COVID-19 disease and HIV specific factors, such as particular cART components, was possible only in few studies (14). In our study, we analyze the risk factors for moderate/severe courses of COVID-19 among HIV-positive patients reported by CEE countries.…”